Comparative assessment of the coloration of tubercle bacilli in the flotation layer of pleural exudate according to Ziehl-Nielsen and Ozol

For the clinician, the detection of tuberculous bacteria in the pleural exudate is of great importance.

APPLICATION OF PLEURAL EFFUSION CRYSTALLOGRAPHY IN THE DIAGNOSIS OF CHRONIC PLEURAL EMPYEMA

An experimental study of facies of pleural exudate obtained from the residual pleural cavity of rats with chronic pleural empyema at different periods of the experiment was conducted. As a result of morphometric analysis of exudate facies, a violation of the structural and spatial organization of the biological fluid and the etiology of pleural effusion was established.

Comparative analysis of the results of bacteriological and chromato-mass-spectrometric studies of pleural exudate in patients with pleural empyema

The OBJECTIVE was to determine the possibility of using chromatography-mass spectrometry to select causal treatment for patients with pleural empyema.METHODS AND MATERIALS. The analysis of the results of examination and treatment of 207 patients with pleural empyema for the period from 2017 to 2018 was done. All patients underwent bacteriological examination, twenty patients from them underwent chromato-mass-spectrometric examination of pleural exudate.RESULTS. Patients were transferred to a specialized thoracic hospital from other medical institutions, where they received a course of empirical antibacterial therapy and drainage of the pleural cavity was performed. Bacteriological examination of the contents of the pleural cavity was positive in 112 (54.1 %) patients. The leading pathogens were gram-negative bacteria isolated from the contents of the pleural cavity in 45 % of patients with closed and 63.5 % – open pleural empyema. Polyantibiotic-resistant stocks of P. aeruginosa (30.4 %), K. pneumoniae (19.6 %) and A. baumannii (12.5 %) prevailed, which remained sensitive to polymyxin and, in some cases, to amikacin. In 25 (22.3 %) patients, micromycetes of the genus Candida were found. No growth of anaerobic microflora was detected. Chromato-mass-spectrometric examination of pleural exudate revealed markers of 30 taxa of bacteria, viruses and fungi that exceeded the norm by more than two times. Markers of gram-negative bacteria were not detected. The proportion of anaerobic microorganisms was 76.6 %, with the highest concentration found for bacteria of the genus Clostridium and Eubacterium.CONCLUSION. The choice of causal treatment for patients with pleural empyema is difficult due to the negative culturing from the contents of the pleural cavity in 45.9 % of patients, as well as the discordance between the results of bacteriological and chromato-mass-spectrometric studies. Diagnostic methods for detecting pathogens of pleural empyema require further improvement.

Etiology and clinical forms of lungs and pleura suppurative diseases of HIV-infected patients

The OBJECTIVE was to study the predisposing factors, pathogenic flora and clinical forms of lungs and pleura suppurative diseases in HIV-infected patients. MATERIAL AND METHODS. The article describes the etiology and clinical forms of lungs and pleura suppurative diseases in 237 HIV-infected patients. Features of damage to the lungs and pleura in these patients were determined. RESULTS. 46 % had empyema with bronchopleural fistula. At endoscopic examination, purulent and purulent-hemorrhagic tracheobronchitis were diagnosed in 27 %. CONCLUSION. Sputum culture or pleural exudate or the contents of a lung abscess cavity were used to determine the etiology of lungs and pleura suppuration in HIV infection. Klebsiella pneumoniae and Pseudomonas aeruginosa played an important role in the development of the disease.

SENSITIVITY OF MULTI-RESISTANT PSEUDOMONAS AERUGINOSA STRAINS DEPENDING ON LOCALIZATION OF INFECTIOUS PROCESS

Objective of work was study of antibiotic resistance peculiarities and isolation localization of multi-resistant Pseudomonas aeruginosa strains. Materials and methods. The objects of investigation were multi-resistant P. aeruginosa strains isolated from pleural exudate, bronchial flushing fluid, blood, samples of wound surface and unaffected skin. Identification of the obtained cultures was carried out for morphological, tinctorial and cultural properties as well as using an automatic microbiological analyzer Vitek 32 (BioMerieux). The selected cultures were tested for sensitivity to a wide range of antibiotics using Vitek 32 (BioMerieux). Results. 18 cultures were selected among P. aeruginosa strains isolated from patients. Correspondingly to antibiotic resistance level, these strains were divided into three groups. The first group includes 7 strains (39%) with maximum resistance, representatives of the second group – 5 isolates (28%) were characterized by high resistance, and 6 cultures (33%) were referred to microorganisms with moderate resistance – the third group. Among 12 strains from the first and second groups, only two cultures were isolated in the intensive care unit. But, four cultures were isolated in the burn department, three – in orthopedics and traumatology, two – in surgery, and one – in proctology. It was found that in 50% of cases (9 strains) the cultures studied were isolated from the wound surface in patients with skin burns and after surgical intervention. At the same time, 3 strains (16% of all microorganisms) were localized in the composition of bronchial washings, as well as 2 strains (11% of all cultures) from pleural exudate and blood. From the abscess and skin of the ear, there was isolated one by one strain (6%). Conclusions. More often P. aeruginosa multi-resistant strains were isolated from the wound surface, however, the microorganisms isolated from pleural exudate were characterized the highest resistance to antibiotics, incl. to meropenem. All studied P. aeruginosa cultures retained sensitivity only to colistin and phosphomycin. The activity of other antibiotics was significantly limited, as only the netilmicin (43% of the sensitive strains), meropenem (41%), amikacin (33%), ciprofloxacin (28%) and norfloxacin (28%) influenced the isolated microorganisms.

Modulation of reactive oxygen species production, apoptosis and cell cycle in pleural exudate cells of carrageenan-induced acute inflammation in rats by rutin

The present study seeks to investigate the effect of rutin, a flavonoid compound in rat models of acute inflammation induced by carrageenan (CAR).

Pancreatic Pseudocyst Pleural Fistula in Gallstone Pancreatitis

Extra-abdominal complications of pancreatitis such as pancreaticopleural fistulae are rare. A pancreaticopleural fistula occurs when inflammation of the pancreas and pancreatic ductal disruption lead to leakage of secretions through a fistulous tract into the thorax. The underlying aetiology in the majority of cases is alcohol-induced chronic pancreatitis. The diagnosis is often delayed given that the majority of patients present with pulmonary symptoms and frequently have large, persistent pleural effusions. The diagnosis is confirmed through imaging and the detection of significantly elevated amylase levels in the pleural exudate. Treatment options include somatostatin analogues, thoracocentesis, endoscopic retrograde cholangiopancreatography (ERCP) with pancreatic duct stenting, and surgery. The authors present a case of pancreatic pseudocyst pleural fistula in a woman with gallstone pancreatitis presenting with recurrent pneumonias and bilateral pleural effusions.